IV. PATHOPHYSIOLOGY(BPH)

Hyperplasia

RISK FACTORS

Androgen

Testosterone

Dihydrosterone

Binds to nuclear androgen receptors

Signals growth factors

Late activation of cell growth

Signals prostate cell to replicate

Become sensitive to growth-stimulating hormone

Estrogen

Apoptosis

5-alpha reductase

Men-50 y/o & above EthnicityDiet Hormonal fxObesity Race DM Family HxSmoking Alcohol use

Exact cause is Idiopathic

LUTS

Hyperplasia

Narrows the lumen of the

segment of the prostate

Encroaches upon the bladder neck

reducing the ability to funnel in response to micturation

Growth of the so-called median lobe

of the prostate extends into the proximal urethra

Prostate capsule influence hyperplasia to expand

outward

Size of prostate

Accompanied by hypertrophy of the smooth muscle gland (Benign Prostatic Hypertrophy)

Muscular tone at the bladder neck & proximal urethra

Mechanically adds to the tse. constricting the urethral lumen

OBSTRUCTION

Urethral resistance

Overwhelms the detrusor muscles ability to ensure effective bladder evacuation by

micturation

UTIHematuria

Amplify the strength of the detrusor contraction

Decline in the force of the urinary stream

Feelings of incomplete bladder

emptying

Daytime voiding frequency

Urgency Nocturia

Symmetrically enlarged gland

Lower Urinary Tract Symptoms

Associated w/ overactive detrusor contractions

Urge urinary incontinence

Detrusor decompensate

Urinary residual volumes

Weakened muscle contraction

Acute Urinary Retention

Uremia

Increase risk of post-operative

complications

Peritonitis